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04/22/2015

ODI plans new health insurance network transparency rule

Source: Health Policy Institute of Ohio

The Ohio Department of Insurance (ODI) has introduced a proposed rule designed to assist Ohioans in determining whether their health providers are included in a health plan’s network (Source: “Rule Aims to Clarify Health Insurance Networks,” The Columbus Dispatch, April 10, 2015).

Lt. Gov. Mary Taylor, who heads the ODI, said the department received 31% more complaints last year than in 2013, and many of those complaints involved a lack of information about who was in or out of their insurance plan’s provider network.

Technical language is still being worked on for the new network-transparency standards, but they should be in place later this year.

The standards would require that insurance directories include up-to-date information about providers, and would require insurance companies and plan administrators to provide documents demonstrating compliance upon request.